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Effects of telerehabilitation-implemented core stability exercises on patient-reported and performance-based outcomes in total knee arthroplasty patients: randomised controlled trial.

BACKGROUND: Face-to-face access to exercise programs, including standard exercises (SE) and core stability exercises (CSE), can be challenging for many total knee arthroplasty (TKA) patients.

OBJECTIVES: To investigate the effects of adding CSE to SE on patient-reported and performance-based outcomes in TKA patients using telerehabilitation (TR).

METHODS: Group 1 (SE, n  = 21) and Group 2 (SE+CSE, n  = 21). Follow-up included videoconferences (1-8 weeks) and telephone calls (9-12 weeks). Assessments (preoperatively and at 1st, 2nd, and 3rd postoperative months) included; Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): functional level, Visual Analogue Scale (VAS): pain intensity, Copenhagen Knee Range of Motion (ROM) Scale (CKRS): knee ROM, Short Form-12 (SF-12) and World Health Organization Quality of Life Brief Version (WHOQOL-BREF): quality of life, 30-s Chair-Stand Test: muscle strength, and Stair Climb Test: locomotor performance.

RESULTS: All assessments showed a significant improvement after treatment in group 1 ( p  < .001, Cohen's d = 0.315 to 0.959) and group 2 ( p  < .001, d = 0.445 to 0.901). There was no significant difference between groups in knee flexion ROM ( p  > .05). Group 2 achieved better results in functional level ( p  = .001 to 0.003,d = -0.334 to 1.207), pain intensity ( p  = .030,d = -0.334), knee extension ROM ( p  = .015,d = -0.374), quality of life ( p  = .001 to 0.046,d = -0.308 to -1.366), muscle strength ( p  = .002 to 0.016,d = -0.779 to -1.030), and locomotor performance ( p  = .004 to 0.009, d = 0.404 to 0.954).

CONCLUSION: SE and SE+CSE via TR enhance patient-reported and performance-based outcomes in post-operative TKA patients, with CSE providing additional benefits. These results support using CSE in TR programs for TKA and encourage further research on TR.

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